The Abridged "Beyond the Birth" Workshop   Enrollment Form
Please take a moment to answer these questions as will help us customize the workshop to meet your interests.
You can expect to receive an email from us within 24 - 48 hours of sending your response!  In the meantime, please email us at info@4thTrimesterPlan.com with questions!
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Name *
Phone Number
Email
Facebook handle
Due Date
MM
/
DD
/
YYYY
Where are you located in the valley
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Which workshop series are you interested in attending?
Twins?
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How many children do you currently have?
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Other children names & ages:
Preferred birth method:
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Preferred birth location:
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OB/GYN or midwife name:
Preferred baby feeding method:
Employment status:
If employed, expected time-off after baby:
Projected employment status after baby:
Partner's expected time off after baby
Food allergies or aversions:
Maternal / Paternal cultural heritage (e.g. as many known countries, regions, or ethnicities):
What do hope to gain from the workshop?
Which best describes your approach to planning?
Clear selection
Check any of the following that describe your situation:
Will your partner attend the session?
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How did you hear about the "Beyond the Birth" workshop?
Is there anything else we should know?
Please select the payment option that works best for you. ($150)
Submit
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